I care for many older couples in this aging small town in which I practice. From time to time one of the couple, usually the man, passes away after a drawn out period of illness and decline often lasting a period of years.
Recently I saw a sweet seventy five year old female who's husband of fifty plus years passed away a month ago. His last two years were studded with multiple medical diagnoses such stroke with hemiplegia and expressive aphasia, recurrent aspiration pneumonia, depression, recurrent falls, and finally a subduralhematoma . Through this time she care for him at home as much as possible often to the detriment of her own health.
Today this widow came into the office to talk to me about her diabetes which was long overdue. Inevitably in these post-spousal death situations I seem to spend as much time debriefing with the living partner what happened and equally as inevitably they tell me, "You know you may find this is surprising, and I loved my husband and all, but in some ways I am so relieved that he passed away."
Now that I've heard this enough times, it really isn't a surprise and it often makes me wonder if much of what we do is the right thing. It gets at the heart of treating illness versus disease. Disease is a medical diagnosis, a pathophysiologic process gone awry. Illness is the total experience of disease including its emotional aspects. Are we inflicting unnecessary suffering in our attempt to treat disease instead of focusing on illness? Are we interfering too much in nature's master plan? Old man's friend (pneumonia) was called old man's friend for a reason.